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The most common injuries and causes of pain in the thigh are hamstring strains (back of the thigh) and quadriceps strains (front of the thigh). The hamstring strain is the most common muscular injury in sport and often reoccurs (re-injury). It is thought that one of the reasons for this is due to poor rehabilitation (not enough time to heal or poor choice of rehabilitation exercise) so it is very important to treat the initial injury correctly and use appropriate timescales to allow for complete healing of the damaged muscle.
Immediate First Aid for Thigh Injuries
The PRICE principles are the gold standard set for treating sports injuries. The acronym stands stands for Protection, Rest, Ice, Compression and Elevation and should be applied as early as possible and continued for at least the first 24-72 hours.
Protection of the damaged tissue is vital to prevent further damage and enable the healing process to start efficiently and effectively. There are a number of ways to protect the injured area all with the same aim of limiting further movement and use of the joint/muscle/ligament/tendon. One way this can be achieved is using a support or splint.
In the early stages, rest is one of the most important components of the P.R.I.C.E principle but is often neglected or ignored. It does not only refer to the prolonged period of time that the athlete will be out of action but also to the immediate period after the injury.
An athlete must know when to stop training and allow the injured area to heal otherwise repetitive minor injuries can often result in a more severe injury that keeps the athlete out for much longer.
If an injury is sustained during sporting activity some athletes have a tendency to 'run it off'. This implies that by continuing to participate in the exercise, the injury will simply go away. In fact, in the majority of cases this is not true and is not advisable.
Ice therapy, also known as cryotherapy, is one of the most widely known and used treatment modalities for acute sports injuries. It is cheap, easy to use and requires very little time to or expertise to prepare.
The application of ice to an injury, in the acute phase can substantially decrease the extent of the damage. It achieves this in a number of different ways:
- Decreases the amount of bleeding by closing down the blood vessels (called vasoconstriction).
- Reduces pain (pain gate theory)
- Reduces muscle spasm
- Reduces the risk of cell death (also called necrosis) by decreasing the rate of metabolism
Ice is usually applied to the injured site by means of a bag filled with crushed ice which is wrapped in a damp towel. The damp towel is essential as it forms a barrier between the bag of ice and the skin and reduces the risk of an “ice burn”. DO NOT leave the ice on for more than 15 minutes as you could cause an “ice burn”.
There are a small number of areas that you should not apply ice to which include the neck, the outside bone of the elbow, the collar bone (upper end), the front of the hip (bony part) and the outer bone of the knee. The reason for this is there is a superficial nerve just below the skin in these areas that can be damaged by applying ice to it. Always check for contraindications.
Applying compression to an injured area minimises the amount of swelling that forms after an injury and should be applied for the first 24 to 72 hours from the onset of injury. Compression can be applied through a number of methods. The most effective of these is by using a compression bandage which is an elasticated bandage that simply fits around the affected limb.
Elevation of the injured limb is the final principle of PRICE but is equally as important as the other 4. Elevation allows gravity to drain the fluid away from the injured site. This aids in decreasing the swelling which in turn may decrease the pain associated with the oedema (swelling).
Should I See a Doctor?
It is very rare that thigh injuries need to seen by a doctor as most are muscular injuries that will heal given the appropriate treatment and rest.
However, if you have the following symptoms then you should seek further medical help.
- Very severe pain in the thigh following a high impact collision such as a high impact collision on a sports field or a Road Traffic Accident. This may indicate a fracture of the femur which is a very serious injury as they tend to be associated with excessive bleeding internally.
- Severe pain in the thigh after and direct impact e.g. opponents knee to the front of the thigh. In some rare cases, the resulting bleeding that occurs can be excessive and lead to compartment syndrome which is a very serious condition.
- Severe pain in the thigh followed by an inability to straighten or bend the knee and a palpable (able to feel) gap in the muscle. This may be a grade 3 rupture of the muscle and may need surgery if it occurs at either end of the muscle at the junction with the bone.
- Altered sensation (“pins and needles” feeling or loss of feeling) in the lower leg following a thigh injury.
Anatomy of the thigh
There are four quadriceps muscles at the front of thigh and three hamstring muscles at the back of the thigh.
Read more on thigh muscles...